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Culture War Roundup for the week of August 4, 2025

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Most of these claims arise in the rare periods of lucidity that bless/curse the severely demented. You get a few good minutes or hours to realize how your brain is rotting, often before your body has, and you realize how awful things have become. Then you slide back into the vague half-life of semi-consciousness, and I hope your mind is choosing to devote its last dregs of cognition to happier memories, instead of the living hell you currently dwell in.

I sometimes think that our approach to euthanasia is stymied by fundamental incompatibilities and contradictions with post-enlightenment principles. We highly prize autonomy and regard as foundational the need for consent. But the ones most in need of euthanasia are those who have declined to the point they no longer meaningfully can consent. And I find it somewhat cruel to imagine a person struggling with a terminal illness or other severe mental or physical suffering, being additionally burdened with having to take the sole decision of if and when to end their life. What a huge question to have to grapple with at the lowest point in your life.

I think there is a serious and tragic problem here; but we lack a suitable cultural programming to adequately solve it. Our focus on preservation of life to the exclusion of all else creates outcomes where people spend months or years existing, suffering, without hope of recovery. An insistence on the inviolable importance of consent means many of those who arguably need it most cannot access euthanasia under any system we could invent. And a belief that any such avenue must be systematized and accountable will create a system overloaded with bureaucracy, hoops to jump through and people covering their asses at every turn in case they go to jail. None of it will be the best interests of the patient.

Both of my father's parents had signed and notarized DNR (do not resuscitate) orders drafted, with copies kept with their lawyer and stuck to the fridge with a magnet, since they were in their early 70s. And they established power of attorney in their children with very clear instructions that when in doubt, pull the plug. It's not exactly euthanasia, but there are steps you can take to pre-establish consent if you're proactive.

It's morbid, but it's never too early to set your affairs in order. Don't trust your fate to the decision-making skills of a dementia-ridden potato and your grieving children.

For once, the Brits are better about this. Living wills and Anticipatory Care Plans are quite common and actively encouraged. You get to have people make these decisions before they become infirm or lose decision-making capacity. Then the family and doctors do their best to follow along.

One set of my grandparents had living wills and the other did not. I can attest that setting up a living will is an incredible gift to your loved ones. It's much easier to make difficult choices when you already have iron-clad proof of someone's wishes back when they were sound of mind.